Factors Associated With Willingness to Receive a COVID-19 Vaccine Among 23,819 Adults Aged 50 Years or Older: An Analysis of the Canadian Longitudinal Study on Aging

Abstract

Identifying those least willing to receive COVID-19 vaccine is critical for increasing uptake via targeted outreach. We conducted a survey of 23,819 Canadian Longitudinal Study on Aging participants from September 29 to December 29, 2020, to assess factors associated with COVID-19 vaccine willingness and reasons for willingness or lack thereof. Among adults aged 50-96 in Canada, 84.1% (95% CI: 83.7-84.6) were very or somewhat willing to receive COVID-19 vaccine; 15.9% (95% CI: 15.4-16.3) were uncertain or very or somewhat unwilling. Based on logistic regression, those who were younger, female, had lower education and income, non-white, and lived in a rural area were less willing. After controlling for these factors, recent receipt of influenza vaccine (aOR=14.3; 95% CI: 12.5-16.2) or plans to receive influenza vaccine (aOR=10.5; 95% CI: 9.5-11.6) compared to not planning to was most strongly associated with COVID-19 vaccine willingness. Willingness was also associated with believing one had never been infected with SARS-CoV-2 and experiencing negative pandemic consequences. Safety concerns were most common. Our comprehensive assessment of COVID-19 vaccine willingness among older adults in Canada, a prioritized group due to risk of severe COVID-19 outcomes, provides a roadmap for conducting outreach to increase uptake, which is urgently needed.

Governmental Incentives, Satisfaction with Health Promotional Materials, and COVID-19 Vaccination Uptake among Community-Dwelling Older Adults in Hong Kong: A Random Telephone Survey

“…Compared to adults aged 65–69 and 70–74 years, those aged 75 years or above reported significantly lower COVID-19 vaccination uptake. A similar trend was observed in Malaysia and Canada [ 13 , 19 ]. Therefore, future health promotional campaigns should target older age groups.…”

“…Worldwide, older adults had a high level of acceptance of COVID-19 vaccination. The prevalence of willingness to receive COVID-19 vaccination among older adults was 91.3% in the United States, 66–92.7% in Italy, 92% in Israel, 84.1% in Canada, 81.7% in Malaysia, 79.1% in mainland China, and 71% in Lebanon and Brazil [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ]. The prevalence of taking up at least one dose of COVID-19 vaccination was high among older adults in most parts of the world, for example, 79.1% in the United States (April 2021) [ 21 ], 94% in the United Kingdom (May 2021) [ 22 ], 94% in Singapore (October 2021) [ 23 ], and 80% in mainland China (November 2021) [ 24 ].…”

“…It is also important to understand determinants of COVID-19 vaccination specific to older adults to develop health promotional campaigns to cater to their needs. To our knowledge, at least 12 studies have investigated factors associated with willingness to take up COVID-19 vaccination among older adults [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ], while fewer studies have looked at factors influencing actual uptake in this group [ 10 , 22 ]. Facilitators identified by these studies included a history of seasonal influenza vaccination [ 18 , 19 , 20 ]; perceived higher risk and severer consequences of COVID-19 [ 10 , 11 , 12 , 14 , 17 , 19 , 20 ]; belief in vaccine efficacy and other benefits [ 10 , 13 , 14 , 15 , 17 ]; trust in vaccination information obtained from social media, friends, or family members [ 11 , 14 ]; higher social support [ 11 ]; and trust in the healthcare system, healthcare workers, or the government [ 11 , 14 ].…”

“…To our knowledge, at least 12 studies have investigated factors associated with willingness to take up COVID-19 vaccination among older adults [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ], while fewer studies have looked at factors influencing actual uptake in this group [ 10 , 22 ]. Facilitators identified by these studies included a history of seasonal influenza vaccination [ 18 , 19 , 20 ]; perceived higher risk and severer consequences of COVID-19 [ 10 , 11 , 12 , 14 , 17 , 19 , 20 ]; belief in vaccine efficacy and other benefits [ 10 , 13 , 14 , 15 , 17 ]; trust in vaccination information obtained from social media, friends, or family members [ 11 , 14 ]; higher social support [ 11 ]; and trust in the healthcare system, healthcare workers, or the government [ 11 , 14 ]. Barriers to receive COVID-19 vaccination found by these studies included ethnicity (Hispanic, Black, or African American) [ 9 , 16 ], lower education or income [ 9 , 19 , 20 ], aged over 70 years [ 13 , 19 ], and concerns about safety and side-effects of the vaccines [ 10 , 15 , 16 , 19 ,…”

“…Facilitators identified by these studies included a history of seasonal influenza vaccination [ 18 , 19 , 20 ]; perceived higher risk and severer consequences of COVID-19 [ 10 , 11 , 12 , 14 , 17 , 19 , 20 ]; belief in vaccine efficacy and other benefits [ 10 , 13 , 14 , 15 , 17 ]; trust in vaccination information obtained from social media, friends, or family members [ 11 , 14 ]; higher social support [ 11 ]; and trust in the healthcare system, healthcare workers, or the government [ 11 , 14 ]. Barriers to receive COVID-19 vaccination found by these studies included ethnicity (Hispanic, Black, or African American) [ 9 , 16 ], lower education or income [ 9 , 19 , 20 ], aged over 70 years [ 13 , 19 ], and concerns about safety and side-effects of the vaccines [ 10 , 15 , 16 , 19 , 20 ]. Most of these facilitators and barriers were similar to those in the general population.…”